Monitoring in the operating room: current techniques and future requirements

Review of a recent lawsuit and study of operating room cardiac arrests reveal that ventilatory problems are a major source of intraoperative morbidity and mortality. Tidal volume and airway gas composition are critical to the anesthesiologist who must determine the depth of an inhalation anesthetic. Yet, current instrumentation does not permit these variables to be measured conveniently. In this paper, current techniques for monitoring cardiovascular physiology are review, and considerable attention is focused on the problem of and the requirements for ventilatory monitoring in the operating room. The high dollar cost of infrequent untoward events is discussed, as well as the additional problem this creates because individual anesthesiologists may receive little positive reinforcement in encouraging the development of more sophisticated monitoring techniques.